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1982737722
RANDALL J. RIDER
FORT WAYNE, IN
NPI
1982737722
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
106H00000X Marriage & Family Therapist
(Licence: IN 35000981A)
Enumeration Date
2007-03-13
Last Update Date
2007-07-08
Business Address
-- RANDALL J. RIDER MS, LSW, LMFT
4235 FLAGSTAFF COVE
FORT WAYNE, IN 46815-4418
Phone number: 260-969-6600
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Mailing Address
-- RANDALL J. RIDER MS, LSW, LMFT
3535 MAXIM DR
FORT WAYNE, IN 46815-6130
Phone number: 260-312-0904
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